Organization
RIVERFRONT MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER CLARK (PRESIDENT)
(315) 451-3906
Entity
Organization
Contact information
Practice address
105 WOODBERRY LN, FAYETTEVILLE, NY 13066-1745
(315) 445-9655
Mailing address
1020 7TH NORTH ST, SUITE 220, LIVERPOOL, NY 13088-6192
(315) 451-3906
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
163502-1
NY
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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